The paper presents the All-Russian consensus on the diagnosis and treatment of celiac disease in children and adults, which has been elaborated by leading experts, such as gastroenterologists and pediatricians of Russia on the basis of the existing Russian and international guidelines. The consensus approved at the 42nd Annual Scientific Session of the Central Research Institute of Gastroenterology on Principles of Evidence-Based Medicine into Clinical Practice (March 2-3, 2016). The consensus is intended for practitioners engaged in the management and treatment of patients with celiac disease. Evidence for the main provisions of the consensus was sought in electronic databases. In making recommendations, the main source was the publications included in the Cochrane Library, EMBASE, MEDLINE, and PubMed. The search depth was 10 years. Recommendations in the preliminary version were reviewed by independent experts. Voting was done by the Delphic polling system.
РезюмеЦель исследования. Сравнить безопасность терапии у больных язвенным колитом (ЯК) и болезнью Крона (БК), получавших комплексную противовоспалительную терапию с применением мезенхимальных стромальных клеток (МСК) костного мозга, и стандартную терапию препаратами 5-аминосалициловой кислоты, глюкокортикостероидами и иммуносупрессорами. Материалы и методы. Неблагоприятные последствия проанализированы у 103 больных (56 с ЯК и 47 с БК) воспалительными заболеваниями кишечника (ВЗК), которым вводили МСК. Полученные результаты сравнили с данными, полученными у 208 пациентов с ЯК и БК, которые находились на стандартной противовоспалительной терапии. Все пациенты сопоставимы по демографическим параметрам, длительности заболевания, протяженности поражения кишечника, характеру течения, форме заболевания, степени тяжести. В анализируемые группы не включали больных, которые получали терапию анти-α-ФНО-препаратами. Безопасность терапии оценивали по наличию осложнений, возникших за время наблюдения. Результаты. Проведя анализ неблагоприятных последствий у 103 больных ВЗК, которым вводили МСК, и сравнив их с результатами лечения 208 больных ЯК и БК, получавших стандартную противовоспалительную терапию, мы не выявили различий в развитии острых посттрансфузионных реакций, инфекционных осложнений, обострений хронических воспалительных заболеваний, тяжелых инфекционных осложнений, злокачественной трансформации и смертельных случаев у больных ЯК и БК, за исключением транзиторной лихорадки. Заключение. Результаты нашего исследования демонстрируют, что инновационный метод клеточной терапии является безопасным для клинического применения.Ключевые слова: безопасность клеточной терапии, мезенхимальные стромальные клетки, болезнь Крона, язвенный колит, воспалительные заболевания кишечника. Aim.To compare the safety of therapy in patients with ulcerative colitis (UC) and Crohn's disease (CD) who have received combination anti-inflammatory therapy using bone marrow mesenchymal stromal cells (MSC) and standard therapy with 5-aminosalicylic acid, glucocorticosteroids, and immunosuppressive agents. Subjects and methods. Unfavorable consequences were analyzed in 103 patients (56 with UC and 47 with CD) with inflammatory bowel disease (IBD) after MSC administration. The findings were compared with data obtained in 208 patients with UC and CD on standard anti-inflammatory therapy. All the patients were similar in demographic parameters, the duration of disease, the extent of intestinal injury, the nature of a course, the type and degree of disease. The analyzed groups did not include patients who had received therapy with anti-TNF-α drugs. The safety of therapy was evaluated from the presence of complications occurring during the follow-up. Results. By analyzing the unfavorable consequences in 103 patients with IBD and comparing them with treatment results in 208 patients with UC and CD on standard anti-inflammatory therapy, the authors revealed no differences in the development of acute posttransfusion reactions, infectious complications, exa...
Aim. To evaluate the effectiveness of enteroprotector Rebamipide in the treatment of enteropathy with impaired membrane digestion (EIMD). Materials and methods. We examined 102 patients aged 18 to 50 years (41 men and 61 women) with clinical signs of irritable bowel syndrome (n=65), functional diarrhea (n=33), and functional constipation (n=4) according to Rome IV criteria (2016). The activities of glucoamylase (GA), maltase, sucrase and lactase were determined by Dahlquist-Trinder method in duodenal biopsies obtained during esophagogastroduodenoscopy. The control group consisted of 20 healthy people aged 23-47. They showed following average enzyme activity: lactase - 42±13 ng glucose on 1 mg of tissue per minute, GA - 509±176, maltase - 1735±446, sucrase - 136±35 ng glucose on 1 mg of tissue per minute. These numbers were taken as the norm. Results and discussion. The activity of the disaccharidases was reduced in 89.2% out of 102 patients, and they were diagnosed with EIMD. Thirteen patients with EIMD were recommended to maintain the FODMAP diet and take enteroprotector Rebamipide 100 mg 3 times a day for 12 weeks. After 3 months 11 patients reported decreased or no flatulence, abdominal pain, stool disorder; 2 patients reported no change. The activity of GA increased to an average of 149±82 (by 78%, p=0.016), maltase - to 864±472 (by 131%, p=0.0019), sucrase - 63±35 (by 95%, p=0.0041) and lactase - 10±8 ng glucose on 1 mg of tissue per minute. The activity of lactase did not change. Conclusion. We discovered a previously unknown phenomenon of the disaccharidases activity increase in duodenal mucosa and improved carbohydrates tolerance in the patients with EIMD taking Rebamipide in the dose 300 mg/day for 12 weeks.
The SARS-CoV-2 virus enters the body through the angiotensin-converting enzyme 2 (ACE-2), which is the entry point of the virus into the cell. The most dense fabric of ACE-2 is the lungs. The small intestine also contains large amounts of ACE-2 in the enterocyte membrane and is often involved in this process. Intestinal symptoms can appear at different stages of the disease. The review describes the mechanisms of interaction of SARS-CoV-2 with enterocytes, the fecal-oral route of infection, diagnosis and treatment of COVID-19 with intestinal symptoms.
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